Healthcare Provider Details

I. General information

NPI: 1356013197
Provider Name (Legal Business Name): HEALTHY HEARTS SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 QUAKER HILL DR APT 420
ALEXANDRIA VA
22314-4779
US

IV. Provider business mailing address

PO BOX 1921
ALEXANDRIA VA
22313-1921
US

V. Phone/Fax

Practice location:
  • Phone: 571-662-0887
  • Fax:
Mailing address:
  • Phone: 571-266-0887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MISS VICKIE SELLERS
Title or Position: FOUNDER
Credential: BHS, QMHP-A
Phone: 571-266-0887